Bedwetting is involuntary urination problem during sleep. Bedwetting occurs in some children even after the age when usually bladder control occurs. Bedwetting is the most common urological problem in children and a frequent pediatric health issue.
Most bedwetting problems are not illness or emotional problems and are only a developmental delay of bladder control. The medical term for bedwetting (also spelled as bed-wetting) is nocturnal enuresis, which can be primary or secondary.
Primary nocturnal enuresis (PNE) is bedwetting when the child has not yet had fairly long period of being dry in the bed during sleep.
In secondary nocturnal enuresis (SNE) a child or an adult starts having bedwetting problem after having remained dry for considerable time.
Secondary nocturnal enuresis is usually a medical condition involving emotional stress and/or bladder infection. As the infant grows, the nerve-muscle coordination as well as control of urine production develops and bedwetting stops.
Two physiological body functions prevent the problems of bedwetting and help a person stay dry during sleep. In human body, there is a hormonal control and suppression of urine production during the night. Arginine vasopressin (AVP), a neurohypophysial hormone which has antidiuretic action, is released by body after dusk.
This hormone release reduces the urine output and the bladder is not full until morning. However this hormone cycle is not present at birth and a child starts developing it around the age of two years.
Many children have the hormone cycle fairly developed by six years, stopping bedwetting. In some children the development may extend up to puberty while for a few it may not develop at all.
The body function contributing to bladder control in sleep is ‘getting awake when bladder is near full’. This sense of awakening when the bladder is full, to counter bedwetting problem, also develops during two to five years of age but is independent of hormone cycle.
Bedwetting problems are encountered more in boys than girls and usually girls start staying dry by sixth year while boys start staying dry by seventh year.
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